[Management of acute radial or ulnar artery injury in hospital emergency department]

Severe arterial injuries in the hand can be hazardous to the limbs and even life- threatening. The aim of this study was to investigate the management methods in the patients with acute injuries of the ulnar or radial artery in the emergency department. Material and This cross-sectional prospective study was conducted in the emergency department of Sina Hospital in Tehran, from 2012 to 2013. Stable vital signs, wrist and forearm laceration with jumper or active bleeding, radial or ulnar artery injury; one or both were among our inclusion criteria. Vital signs, level of consciousness, coincident injuries were assessed and physical examination was performed in all patients. We recorded time of patient arrival, primary and secondary treatment, and consultation and follow up visits in emergency department or ward. 50 patients [3 females and 47 males] with a mean age of 30.34y +/- 9.69y were enrolled. The first step was to examine and pack up bleeding. The most common injury was due to sharp instruments [84%] and the most common injured artery was radial artery [68%].The mean duration of the first treatment was 1.24 +/- 0.93 min. 37 patients [74%] were treated by ligation in the emergency room and the remaining 13 patients [26%] were sent to the operating room for repair and vascular anastomosis by our vascular surgeon. Mean values of duration for ligation were 16.72 +/- 13.83 min and 117.76 +/- 114 min in emergency medicine and vascular surgery groups, respectively that showed a significant difference between the two groups [p= 0.0001]. The overall duration of hospitalization for the patients was 69.04 +/- 82.74 hour [5- 311 hours]. Conclusions: We can conclude that the radial or ulnar artery ligation considering its indications or contraindications, in emergency room can play an important role in the recovery of patient's hemodynamic status and speed up of the next step of patient's treatment

Serum Sodium and Potassium Levels in Cerebro-vascular Accident Patients

Background: We aim to assess serum sodium and potassium levels in patients with different types of cerebro-vascular accidents (CVA) in comparison to control group. Methods: A comparative cross-sectional study conducted on patients admitted to the emergency department from January to August 2012. Control group consisted of patients admitted to emergency department due to common cold, urinary tract infection, low back pain, cluster, and tension headache or migraine. Serum sodium and potassium levels were measured via standard laboratory methods. Results: There were 77 patients in control group and 78 in CVA group. Forty nine patients from the CVA group had ischemic CVA, 11 had hemorrhagic CVA and 18 suffered a transient ischemic attack (TIA). Serum sodium level in control group was significantly lower than in patients with TIA, ischemic CVA, and hemorrhagic CVA (P < 0.001). Serum potassium level in control group was higher than patients with TIA, ischemic CVA, and hemorrhagic CVA (P < 0.001). Patients with hemorrhagic CVA showed significantly lower serum potassium level than patients with TIA and ischemic CVA (P < 0.001). Correspondingly, it was observed that serum sodium to potassium ratio was higher in patients with TIA, ischemic CVA, and hemorrhagic CVA (P < 0.001). In patients with hemorrhagic CVA serum sodium to potassium ratio was higher when compared to patients with TIA and ischemic CVA (P < 0.001). Conclusion: This study shows that higher serum sodium and lower serum potassium level may be associated with higher incidence of CVA. Further studies are paramount to elucidate the role of serum electrolyte levels in vascular events.

Burden of circulatory system diseases and ignored barriers of knowledge translation

Circulatory system disease raise third highest disability-adjusted life years among Iranians and ischemic cardiac diseases are main causes for such burden. Despite available evidences on risk factors of the disease, no effective intervention was implemented to control and prevent the disease. This paper non-systematically reviews available literature on the problem, solutions, and barriers of implementation of knowledge translation in Iran. It seems that there are ignored factors such as cultural and motivational issues in knowledge translation interventions but there are hopes for implementation of started projects and preparation of students as next generation of knowledge transferors

Biocompatibility study of a hydroxyapatite-aiumina and silicon carbide composite scaffold for bone tissue engineering

To date, several scaffolds have been fabricated for application in bone tissue repair. However, there remains a need for synthesis of scaffolds with better mechanical properties, which can be applied to defects in weight-bearing bones. We constructed a composite ceramic bioscaffold of hydroxyapatite-alumina and silicon carbide [HA-Al2O3- SiC] to take advantage of the mechanical properties of this combination and show that it supports osteoblast-like cell attachment and growth. Ceramic composite microporous scaffolds were synthesized using an organic template [commercial polyurethane sponge with an open, interconnected microporosity]. Osteoblast-like cells [Saos-2] were then cultured on the scaffold and their growth pattern and viability were compared with those cultured in cell culture-treated flasks. Scanning electron microscopy [SEM] was used to assess cell attachment and migration. The fabricated scaffold shows fairly uniform pore morphologies. Cell growth and viability studies show that the scaffold is able to support osteoblast attachment and growth. However, SEM images indicated that the cells do not spread optimally on the scaffold surfaces. Our data suggest that that a ceramic hydroxyapatite-alumina and silicon carbide composite scaffold is a viable option for bone tissue repair. However, its surface properties should be optimized to maximise the attachment of osteoblasts